Baltimore City recorded 13,272 premature deaths from to 2008 to 2010, while 4,105 people died prematurely in Howard County during that same period, the most recent data available.

About 19 percent of people in Baltimore are in poor health compared to 8 percent in Howard County. Thirty-one percent of adults in Baltimore are obese, compared to 25 percent in Howard.

"These rankings show that when it comes to staying healthy, we know what works," Howard County Executive Ken Ulman, said in a statement. "When you set a goal of becoming a model public health community; when you partner with community organizations, faith groups, businesses and others to promote healthy lifestyles; when you provide access to health care, to recreation and to information and resources, you get great results."

The annual rankings look at health data in almost every county in all 50 states. The data is compiled from many sources, including the Centers for Disease Control, the National Center for Health Statistics, the U.S. Census and the USDA.

The five healthiest counties in Maryland were Howard, Montgomery, Queen Anne's Frederick and Carroll. The five counties with the worst health were Baltimore City, Allegany, Dorcheter, Somerset and Caroline.

Howard County has been named the healthiest in Maryland for the fourth straight year by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, according to rankings released Wednesday.

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